Bladder Cancer

It was once thought that after guiding the development of male sex organs in a fetus, the Y chromosome did not do much else. But over the past few years, results from multiple studies have challenged that belief.

Updated results from a large clinical trial confirm that, for some patients with bladder cancer that can be removed with surgery, receiving immunotherapy immediately afterwards is an effective treatment.

During the 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium, a panel of experts identified some of the key challenges to achieving health equity in bladder cancer care and discussed what can be done to improve access to clinical trials, mitigate financial toxicity, and promote value-based care.

On December 22, 2022, the FDA accelerated the approval of mosunetuzumab-axgb (Lunsumio; Genentech), a bispecific CD20-directed CD3 T-cell engager, for adults with relapsed or refractory follicular lymphoma after ≥2 lines of systemic therapy. The FDA granted this indication breakthrough therapy and orphan drug designations.

Patients with advanced urothelial carcinoma and disease progression after treatment with platinum-based chemotherapy and PD-1 or PD-L1 inhibitors have limited treatment options. Enfortumab vedotin (Padcev), a Nectin-4–directed antibody and microtubule inhibitor conjugate, demonstrated an objective response rate (ORR) in more than 40% of patients with advanced urothelial carcinoma who had progression after previous treatment.

Interim analysis of the phase 3 JAVELIN Bladder 100 clinical trial showed that maintenance therapy with the PD-L1 inhibitor avelumab (Bavencio) plus best supportive care significantly prolonged overall survival (OS) versus best supportive care alone in patients with advanced urothelial carcinoma whose disease did not progress with first-line platinum-based chemotherapy.

Adjuvant therapy with atezolizumab (Tecentriq) did not meet the primary end point of disease-free survival (DFS) in patients with muscle-invasive urothelial cancer (MIUC) at high risk for recurrence versus observation alone in the primary analysis of the IMvigor010 trial.

On December 2, 2019, Merck announced that the FDA has granted priority review for its supplemental biologics license application for the anti–PD-1 agent pembrolizumab (Keytruda).

Urothelial carcinoma is the most common subtype of bladder cancer, accounting for more than 90% of bladder cancer diagnoses in the United States. In 2017, more than 79,000 bladder cancer cases were diagnosed in the United States, and more than 16,000 people died from this disease. The prognosis is favorable for patients with localized disease, with a 5-year relative survival rate of 78% for all stages of bladder cancer, which decreases to 5% for patients with distant disease.

Urothelial carcinoma is the primary subtype of bladder cancer, which is the sixth most common cancer in the United States. More than 79,000 cases of bladder cancer were estimated to be diagnosed, and nearly 17,000 people to die from this disease in 2017.